Septic Shock with Acute Kidney Injury due to Obstructive Uropathy by Uterine Prolapse, Documented in a Urodynamic Study / 대한내과학회지

ABSTRACT

A 76-year-old woman with high fever and low blood pressure was admitted to the intensive care unit with a diagnosis of septic shock of unknown cause. A meticulous physical examination revealed a uterine prolapse with marked lower abdominal distention, suggesting urinary retention. After manual reduction of the uterine prolapse and insertion of a urinary catheter, the patient was managed with antibiotics for a presumed urinary tract infection. Escherichia coli was cultured on urine and blood culture media. Several days later the patient underwent a gynecological operation (anterior-posterior colporrhaphy) to correct the underlying cause of the obstructive uropathy. A preoperative and postoperative urodynamic study demonstrated marked urinary retention due to uterine prolapse. Pelvic organ prolapse including the uterus is not rare in older women. However, this common gynecological problem can cause lethal obstructive uropathy, such as uroseptic shock and acute kidney injury, if complications are present.